Vanetta Perkins
Jackson
Summary
Health Advisor experienced handling high volume of calls in fast-paced call center environments. Well-versed in answering questions, researching problems, and resolving discrepancies. Detail-oriented and personable with exceptional work ethic and passion for service.
Overview
11
11
years of professional experience
Work History
Health Concierge
Aetna
08.2024 - Current
- Assisted individuals, families and healthcare providers, regarding coverages for commercial health plans and claim processing.
- Provided information such as copay and premium details, pre-approval procedures and available products.
- Helped members navigate enrollment process and choose appropriate options.
- Maintained full and current understanding of available plans, products and services.
- Resolved problems related to benefits, eligibility and claims.
- Resolved customer complaints using established follow-up procedures.
Customer Service Representative
Accenture
12.2023 - 05.2024
- Answer calls, chats or emails and respond all requests, requirements, concerns, questions, complaints and claims of the customer related to services rendered/to be rendered by the New Mexico Department of Human Services.
- Apply problem solving skills to resolve customer inquires and disputes, and escalated using appropriate channels when necessary.
- Kept accurate records of all interactions, including customer names, addresses, phone numbers, card information.
- Created a new customer applications for Human Services benefits by entering customer information into a database and submitting to case workers for final review and distribution on services.
- Provided accurate information regarding, payments and available funds for CASH/SNAP clients, including reporting any suspected fraud or lost cards.
- Meet and exceed daily goals, including high call volume and appointment setting; consistently earned top survey satisfaction scores.
Small Structure Property Adjuster
American Family Insurance
03.2023 - 12.2023
- Developed advanced knowledge of insurance policies and procedures to properly adjust property losses.
- Used Xactimate to compile estimates for personal property and structure damage; prepared sketch of floor plan and roof line and entered data into Xactimate to develop line-by-line item costs of damages.
- Investigated claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss.
- Carefully reviewed claim information to verify accuracy and avert fraudulent claims. Examined claims forms and other records to determine insurance coverage.
- Followed up with insured individuals regarding premium and deductibles payments.
- Maintained contact with claimants and attorneys to determine treatment status.
- Coordinated and managed field investigations, outside engineers, contractors and cause and origin experts.
Underwriting Assistant - Interviewer I
Mutual of Omaha
09.2022 - 01.2023
- Supported underwriters in tasks related to underwriting and administration support by reviewing policy forms for accuracy prior to finalizing documents for issuance.
- Assist Underwriters in identifying potential areas of improvement within the process workflow.
- Receive, analyze and process interview requests from the underwriter and contact applicant via telephone to complete health interviews.
- Respond to customer requests via telephone and email and effectively answered questions and inquiries.
- Copied, logged and scanned supporting documentation and placed all information in client files, verifying insurance coverage for any changes.
- Contact physicians offices to obtain additional information and needed CPT/ICD 10 codes.
- Communicate effectively with applicants and internal and external team members through phone and email, demonstrating good decision making skills, communication both verbal and written and a high level of customer service.
Billing and Enrollment Specialist I
Humana Government Business / Humana Military
12.2021 - 08.2022
- Used online call tracking system to document activities and communications from members, providers and customers.
- Answer approximately 100 incoming calls daily utilizing a courteous and professional manner to collect information and identify customer needs.
- Explained features, advantages and disadvantages of various policies to promote sale of insurance plans.
- Ensured that policy requirements were fulfilled, including any necessary medical examinations and completion of appropriate forms.
- Verified and communicated effectively and professionally copays, co shares for medical visits and hospital stays.
- Utilization of various systems to update and upload need documents, including recurring credit cards, ACH/EFT and allotment forms for monthly and annual premium payments.
- Communicated effectively via telephone, email and in person with prospective customers, thoroughly explained services provided to customers and potential customers.
Dispatcher/Customer Service
Transdev
01.2019 - 10.2021
- Assisting public transportation passengers with bus route information.
- Dispatching morning para transit and public transit buses ensuring they are on schedule and assisting with any needs of the driver.
- Scheduling transportation to needed appointment for para transit passengers.
- Assisting the Operations Manager, Safety and Training Manager and Operations Analysts as needed with data input, training, schedules and reports.
- Executed company policies, procedures, and safety standards to ensure the proper cleanliness and safety of the office and equipment.
Customer Service Representative
RevClaims
12.2014 - 12.2018
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Send invoices and medical records as requested to auto insurance adjusters with verified CPT codes that correlated with services rendered for third party liability claims.
- Assisted hospitals in North Carolina on a third party basis to coordinate benefits between hospitals and motor vehicle insurance after an accident.
- Review medical records and invoices in EPIC hospital system.
- Trained new customer service representatives on the proper handling of customer inquiries.
Education
English
Jackson State University
Jackson, MS04.2012
Skills
- Microsoft Office
- Documentation review
- Conflict Resolution
- Salesforce
- Data entry proficiency
- Inbound call management
Timeline
Health Concierge
Aetna
08.2024 - Current
Customer Service Representative
Accenture
12.2023 - 05.2024
Small Structure Property Adjuster
American Family Insurance
03.2023 - 12.2023
Underwriting Assistant - Interviewer I
Mutual of Omaha
09.2022 - 01.2023
Billing and Enrollment Specialist I
Humana Government Business / Humana Military
12.2021 - 08.2022
Dispatcher/Customer Service
Transdev
01.2019 - 10.2021
Customer Service Representative
RevClaims
12.2014 - 12.2018
English
Jackson State University
Similar Profiles
Toni BasalduToni Basaldu
Care Management Associate Manager at AetnaCare Management Associate Manager at Aetna
Kristine Tortorich (Kristy)Kristine Tortorich (Kristy)
RN Care Manager at AetnaRN Care Manager at Aetna
Revathi MallineniRevathi Mallineni
Data Analyst at AetnaData Analyst at Aetna
Kimberly WernerKimberly Werner
Case Manager at AetnaCase Manager at Aetna
Christine CummingsChristine Cummings
Vice President, Sales & Service Contact Center Ops at CARiD (Auto Parts, LLC)Vice President, Sales & Service Contact Center Ops at CARiD (Auto Parts, LLC)